Active NPI
Dimitry Polyakov, DPT
- Physical Therapist
- Chatham, NJ
National Provider Identifier
1841509940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40QA00635300
- Practice address
- 13 Watchung Ave
Total Physical Therapy
Chatham, NJ 07928 - Phone
- (908) 268-1913
- Fax
- (973) 701-1616
- NPI assigned
- Oct 7, 2010
- Last updated
- Oct 7, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 40QA00635300 | NJ | Primary |
Addresses
Primary practice location
13 Watchung Ave
Total Physical Therapy
Chatham, NJ 07928
Mailing address
13 Watchung Ave
Total Physical Therapy
Watchung, NJ 07928
Phone (908) 268-1913
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40QA00635300 | NJ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1286409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1286409600000",
"number": "1841509940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13 WATCHUNG AVE",
"address_2": "TOTAL PHYSICAL THERAPY",
"city": "WATCHUNG",
"state": "NJ",
"postal_code": "07928",
"telephone_number": "908-268-1913",
"fax_number": "973-701-1616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13 WATCHUNG AVE",
"address_2": "TOTAL PHYSICAL THERAPY",
"city": "CHATHAM",
"state": "NJ",
"postal_code": "07928",
"telephone_number": "908-268-1913",
"fax_number": "973-701-1616"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLYAKOV",
"first_name": "DIMITRY",
"name_prefix": "Mr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-10-07",
"last_updated": "2010-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA00635300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chatham, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.